Isosorbide Dinitrate Safety in Pediatric Patients

Lack of Pediatric Evidence and Guidelines

• The American Academy of Pediatrics provides comprehensive medication dosing for pediatric patients, but does not include isosorbide dinitrate in any recommended treatment algorithms, highlighting the lack of established pediatric safety profiles for this medication 1
• No pediatric dosing guidelines exist in major cardiovascular guidelines for children, which instead focus on medications with established pediatric safety profiles such as ACE inhibitors, beta-blockers, and calcium channel blockers for hypertension management 1

Adult-Only Indications and Guidelines

• The American College of Cardiology and American Heart Association specify the use of isosorbide dinitrate only in patients ≥18 years of age who are self-identified as Black or African American with NYHA class III-IV heart failure, indicating a lack of evidence for its use in pediatric populations 2, 3, 4